Caution with cold and flu drugs

Tuesday

Dec 23, 2008 at 3:00 PM

Everyone wants effective medicines to treat colds and flu but finding such drugs has been very difficult.The FDA has reported that cold and cough medicines have likely killed at least 123 children and has raised serious questions about the safety of nonprescription cough and cold products in children and whether the benefits and costs justify any potential risks, particularly in kids under 2 years of age.I have previously expressed my view that it is totally unacceptable to be marketing medications to infants and children that likely do not work and that may have fatal consequences. No new breakthroughs have been made in this area. As for the flu, it accounts annually for 200,000 hospitalizations and 36,000 deaths and we play a “guessing game” in trying to match flu vaccines with the current strains.Last year’s vaccine was only 44 percent effective overall, according to the CDC. Health officials say that only about 30 percent of U.S. adults have gotten a flu vaccination this flu season. Now, the CDC is saying that a leading flu medicine, Tamiflu (oseltamivir), might not work against all cases of the flu. They stated that, “Early tests indicate that 49 of 50 samples of the main flu virus circulating this year — H1N1 — were resistant to Tamiflu.” Predictably, Roche, Tamiflu’s manufacturer, said that it is too early to draw strong conclusions regarding its usefulness.Flu viruses changed or mutate dramatically and older drugs such as amantadine and rimantadine, used during the 2005-2006 flu season are no longer effective. Resistance is developing to Tamiflu and scientists are baffled that it seems to have nothing to do with actual use of Tamiflu. Tests across the United States, Canada and Mexico showed very quick development of drug resistance among H1N1 viruses.As of May 15, resistant viruses had been detected in 18 states out of 43 where virus samples from patients were tested.New labels have been ordered for prescription flu medicines, Tamiflu and Relenza, because of reports of abnormal psychiatric behavior. In 2007, FDA staff described reports of about 700 cases of psychiatric adverse events for both drugs and 25 cases of pediatric deaths in patients taking Tamiflu, but no fatalities were reported for Relenza. In the America that I love, we will always consult our doctors and we will pressure drug companies to keep us honestly informed about the effectiveness and potential for harm of all of our medications. Potentially harmful or fatal drugs are commonly given to the elderly and the very young, so extra caution should be exercised. Colds and flu are nothing to sneeze at.Dr. Randolph M. HowesKentwood

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